This is a proposal for follow-up assessments at age 11 in an ongoing longitudinal study of children classified by low birthweight (LBW) status at birth and assessed at age 6. In the United States, a continuing high rate of LBW and an increased survivorship of LBW infants constitute compelling reasons for longitudinal research on the neuropsychiatric sequelae of LBW. The proposed follow up study builds on a growing body of research focused primarily on the school age sequelae of very low birthweight (less than 1,500 or less than 1,000g). By comparison, this study covers the entire range of LBW (less than 2,500g), exposing a potential gradient of psychiatric sequelae not observable in prior studies. We have recently completed assessments at 6 years of age of a random sample of 823 children, 473 LBW and 350 normal birthweight children (NBW) (more than 2,500g), selected from the 1983-1985 newborn lists of two major hospitals in Southeastern michigan, one int he central city of the metropolitan area and the other in a nearby middle class suburb. The results suggest adverse effects of LBW on Attention Deficit-Hyperactivity Disorder (ADHD), attention problems, IQ, and neurocognitive skills predictive of Learning Disorders, controlling for suspected confounders, such as maternal IQ and education. Level of LBW showed a graded relationship with most of these outcomes. Nonetheless, even children with middle and high LBW had worse outcomes than NBW2 children. This proposal is for an additional wave of assessments that will extend the investigation to age II. Children will be assessed, using the NIMH-DISC to measure ADHD and other psychiatric disorders, standardized academic achievement tests, and the same neuropsychologic battery, teachers' and parents' child behavior rating scales as used at the 6 years assessment. On the basis of extensive experience in follow-up studies, a 85% completion rate is anticipated. Children will be assessed in 1995-1997, as they pass age 11. Hypotheses will be tested about risks for ADHD and other psychiatric disorders, Learning Disorders, and poor academic achievement in LBW children at 11 years of age. Using the available data on the 6 year assessment together with data from the proposed follow-up assessment, we will attempt to identify early precursors of psychiatric disorders, Learning Disorders, and low academic achievement in LBW children. Information from this study would clarify the long term psychiatric sequelae of LBW and the mental health and education needs of LBW children in socially disparate populations.